Friday, April 1, 2011

Guest Blogger: Dr. Richard Mabry

It's always a pleasure to have Dr. Mabry here at Redwood's Medical Edge. He's a great supporter of this blog and it's my pleasure to have him here on the day when his latest novel, Diagnosis Death, is released and that's no April Fool's joke. Welcome back Dr. Mabry!

“WHERE DO YOU GET YOUR IDEAS?”
I don’t believe I’ve ever spoken to a group of non-writers without being asked this question: “Where do you get your ideas?” I’ve been tempted at times to tell them I use a book titled 1001 Story Ideas For Writers and send them scurrying to find that non-existent volume. Or refer them to a spurious website called http://www.freebookideas.com/. But instead, I tell them the truth. I get my ideas from following the advice given me years ago by author Alton Gansky. “Ask yourself the question: ‘What if…?’”

Let me give you an example. My third novel of medical suspense, Diagnosis Death, officially releases today. In it, Dr. Elena Gardner, is accused of the mercy killing of several patients, one of whom was her critically ill husband. The twist is that she can’t really defend herself, because she can’t be sure her accusers are wrong. Sorry, you’ll have to buy the book to learn more about it, but let’s backtrack to the way I came up with that plot.
About the time I was casting about for a storyline for this book, the aftermath of Hurricane Katrina brought forth a story that caught my eye. A colleague of mine in New Orleans was accused of ending the life of four terminally ill patients trapped in the unspeakably difficult conditions of the hospital where she worked with no hope in sight of rescue. She was subsequently exonerated in the courts, and I won’t say anything further here about the case, but it brought to mind the subject of euthanasia and end-of-life decisions.
There was another factor in my choice of subject matter. I had first-hand experience with withdrawal of life support, not just as a physician, but in the case of my first wife, who suffered a devastating stroke. I knew how it worked, and knew all too well the emotional roller coaster associated with making that decision, as well as the guilt that followed it. So that was the way I got the idea that evolved into Diagnosis Death.
Alton Gansky told the class I was in that he keeps a file of three by five cards with story ideas, and it’s unlikely he’ll ever run out. I don’t have such a reserve, but I do have an almost endless supply of potential material. I read the newspapers. I watch TV. I talk with other people. In the world around us are story lines galore. We just have to use a little imagination and ask ourselves, “What if…?”
Here’s one final example. I read not long ago in a medical journal about a great new antibiotic, effective where other drugs had failed. So I asked myself, “What if that wonder drug really has potentially dangerous side effects, but someone falsified the research data to make it look good?” That’s the theme, by the way, of my fourth novel, Lethal Remedy, due out September 1.
So ask yourself, “What if…?” Then start writing.
Look at the news today... what plot idea can you come up with?
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Dr. Richard Mabry built a worldwide reputation as a clinician, researcher, and teacher before retiring from medicine. His published series, Prescription for Trouble, under Abingdon Press includes Code Blue and Medical Error. Diagnosis Death released today! Dr. Mabry is also current Vice President of the American Christian Fiction Writers group. You can learn more about him at his website and follow him on his blog.

Wednesday, March 30, 2011

Medical Question: Illness early 1980's.

AJ Luck asks:
I just found your website and I have to say….I am hooked! What a great concept!!
I am a fiction writer currently working on a spiritual thriller project.
I have a character that is in her late 70’s in the early 1980’s. Ideally I would like her to suffer about a year before passing away. I need to find a way to have her pass away-possibly in her sleep. I need to find something semi complex for that era that would allow her to hide the (fatal) disease, at least for a considerable amount of time.
I would love your thoughts!!
Thanks so much!
Jordyn says:
Here are a few ideas for your illness.
Cancer: There are a couple of cancers that when discovered, even with treatment, death might occur in about a year. A few to consider would be brain, liver, pancreas or kidney.
Neurological Disease: Here you could do a rapidly progressing ALS which is also known as Lou Gehrig's Disease.
Cardiac: In general, she could have congestive heart failure. There are a number of causes. This could have her feeling generally unwell for a long time and then you could have sudden death really at any point in your story line. Here's a blog post I did along those lines.
Hope this helps AJ and good luck with your novel!
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AJ is a Christ follower trying to encourage others by being transparent in her trials and triumphs. You can find her a http://randomnessofluck.com/.

Monday, March 28, 2011

A Humor Break: Physician, know thyself.


I got this diagram e-mailed to me from a nurse friend of mine. It gave me a good laugh. Those that work in medicine can appreciate this as there seems to be these diagram boxes for everything. This one goes over how a medical student might find their specialty. Now, I don't know who to credit it to. So, if anyone knows, please e-mail me. And, if you find one for nursing, I'd be happy to post it.




I think the diagram does lend to the fact that certain medical specialties attract certain personalities. Nursing is no different. For instance, I happen to believe a lot of labor and delivery nurses have been cheerleaders in the past. Wouldn't you have to love to do that to get all those women through labor? What do you think the personality type is for a neurosurgeon, a podiatrist, or a family practice doctor? What about for an ER nurse, a neonatal nurse or a medical/surgical nurse?

Friday, March 25, 2011

Medical Myth: Head Injured Patients Need to Stay Awake


I love the series Dexter. If you're unfamiliar with it and you're a writer, I think it's a great exercise in intricate plotting techniques. However, it is violent, so proceed with caution. The general premise is that Dexter works for Miami Police as a blood splatter specialist. In his free time, he's a serial killer, but only kills those that the justice system doesn't put away. This show is also good study for the sympathetic villain.

In one episode, poor Dexter has been in a motor vehicle collision. He is dazed and is taken to the ER. The doctor says something to the effect of, "You have a head injury. You'll need to stay awake for the next several hours." Great.

Sleepiness post head injury is a classic set-up for pediatrics. Every day in the ER is a story like this. It's close to bed time. The children are running amok. Some child falls down, falls into, or falls off of something and hits their head. They cry their little heart out. After all, hitting your head hurts, a lot. After a good crying bout, they're sleepy. Parents first thought is, he must have a terrible head injury. Off to the ER.

Now, one, I want to make it clear. Getting your child checked in the ER for head injury is good and reasonable. However, we aren't all that concerned with sleepiness. What we are concerned with is how arousable they are from sleep. This is what we'll be monitoring every fifteen minutes to an hour if the child sleeps during his ED visit.

Level of consciousness is assessed as an indicator of an injury going on inside of the head. How arousable you are is the most sensitive indicator of level of consciousness. If the child falls asleep, and we are concerned about head injury, we'll try to wake them up every so often to assess their level of arousability. If we cannot wake them up, then we are concerned. It has to be more than a gentle nudge. You are really working to wake the patient and they won't respond. This is concerning.

Remember, things that are injured need rest. This is why we put you on crutches if you break an ankle. The brain rests by sleeping. It helps it to heal. If you're a subscriber to this myth, how long should we keep the patient awake? An hour? Two hours? A day? If you want a skewed neuro exam, try doing one on a sleep deprived patient.

For additional resources regarding this myth, check out the following:

1. http://firstaid.about.com/od/headneckinjuries/f/09_Waking_Heads.htm

2. http://familydoctor.org/online/famdocen/home/common/brain/head/084.html

Did you believe this myth?